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COOLER RECEIPT CHECKLIST Curtis&Tompkins,Ltd. <br /> Login# 73n-fl;, Date Received 71I-91112 Number of coolers � <br /> Client Ferthrwch Inc. Project 34D TYllC{" <br /> Date Opened T1111I2 By(print) i ilMl L �tXt _(sign) <br /> Date Logged in By(print) (sign) I <br /> 1. Did cooler come with a shipping slip (airbill, etc) YES <br /> Shipping info <br /> 2A. Were custody seals present? .... ❑YES (circle) on cooler on samples XNO <br /> How many Name Date <br /> 2B. Were custody seals intact upon arrival? YES NO <br /> 3. Were custody papers dry and intact when received? NO <br /> 4. Were custody papers filled out properly(ink, signed, etc)? NO <br /> ' 5. Is the project identifiable from custody papers? (If so fill out top of form)­9 NO <br /> 6. Indicate the packing in cooler: (if other,describe) <br /> ❑Bubble Wrap ❑Foam blocks ❑Bags ZNone <br /> ❑Cloth material ❑Cardboard ❑Styrofoam ❑Paper towels <br /> 7. Temperature documentation: •Notify PM if temperature exceeds 6°C <br /> Type of ice used: ® Wet ❑Blue/Gel ❑None Temp(OC) 20 <br /> ❑ Samples Received on ice&cold without a temperature blank;temp. taken with IR gun <br /> 9 Samples received on ice directly from the field. Cooling process had begun <br /> ' 8. Were Method 5035 sampling containers present? YESO <br /> If YES,what time were they transferred to freezer? <br /> 9. Did all bottles arrive unbroken/unopened? NO <br /> 10. Are there any missing/extra samples? YES 0) <br /> 11. Are samples in the appropriate containers for indicated tests? NO <br /> 12. Are sample labels present, in good condition and complete? NO <br /> 13. Do the sample labels agree with custody papers? NO <br /> 14. Was sufficient amount of sample sent for tests requested? § NO <br /> 15. Are the samples appropriately preserved? YES NO10/ <br /> 16. Did you check preservatives for all bottles for each sample? YES NO <br /> 17. Did you document your preservative check? YES NO dDk <br /> 18. Did you change the hold time in LIMS for unpreserved VOAs? YES NO <br /> 19. Did you change the hold time in LIMS for preserved terracores? YES NO / <br /> 20. Are bubbles>6mm absent in VOA samples? YES NO <br /> 21. Was the client contacted concerning this sample delivery? YES <br /> If YES, Who was called? By Date: <br /> COMMENTS <br /> ' Rev 10, 1 I/1 I <br /> 4of81 <br />